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1639925191
DOMINIQUE MICHELLE MANGANO MACK
GOODYEAR, AZ
NPI
1639925191
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LAC-22735)
Enumeration Date
2024-04-25
Last Update Date
2024-05-01
Business Address
DOMINIQUE MICHELLE MANGANO MACK LAC
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395-2713
Phone number: 480-964-2273
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Mailing Address
DOMINIQUE MICHELLE MANGANO MACK LAC
19819 W MARSHALL AVE
LITCHFIELD PARK, AZ 85340-5426
Phone number: 708-209-9952
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